Therapeutic effect of alprostadil combined with tripterygium glycosides on diabetic nephropathy and its effect on inflammatory factors / 中国基层医药

ABSTRACT

Objective To investigate the efficacy,safety of alprostadil combined with Tripterygium wilfordii polyglycosides in the treatment of patients with diabetic nephropathy and its influence on inflammatory factors . Methods From December 2015 to June 2018, 100 patients with diabetic nephropathy admitted to Dajiangdong Hospital were randomly divided into two groups according to the digital table ,with 50 cases in each group.The control group received oral administration of Tripterygium wilfordii glycosides ,the observation group received combined use of alprostadil intravenous infusion.The efficacy,safety and expression of serum TNF －and IL－6 were observed in the two groups.Results Before treatment, the fasting blood glucose,2 h postprandial blood glucose and glycosylated hemoglobin of the control group were (8.87 ±0.65)mmol／L,(12.26 ±1.57)mmol／L,(8.15 ±0.56)%,respectively, which of the observation group were (8.69 ±0.72)mmol／L,(12.41 ±1.64)mmol／L,(8.12 ±0.49)%,respectively, and there were no statistically significant differences between the two groups (t＝0.78,0.69,0.72,all P＞0.05).After treatment,the fasting blood glucose ,2 h postprandial blood glucose and glycosylated hemoglobin of the control group were (7.34 ±0.61) mmol／L,(10.04 ±1.40) mmol／L,(7.28 ±0.53)%,respectively,which of the observation group were (6.93 ±0.39)mmol／L,(8.57 ±1.33)mmol／L,(6.21 ±0.44)%,respectively.The blood glucose of the two groups was significantly improved (t＝4.13,5.75,3.69,5.25,all P＜0.05),and the blood glucose indicators of the observation group were significantly improved compared with the control group ( t ＝3.56,4.28,4.12,all P＜0.05).Before treatment,the 24－hour urinary protein quantification ,urine beta 2－microglobulin in the control group were (0.27 ±0.05)g／L and (0.12 ±0.05)mg／L,respectively,which in the observation group were (0.26 ±0.06)g／L, (0.12 ±0.04)mg／L,respectively,there were no statistically significant differences between the two groups (t＝0.58, 0.63,all P＞0.05).After treatment,the 24－hour urinary protein quantification ,urine beta 2－microglobulin in the control group were (0.19 ±0.04)g／L,(0.08 ±0.04)mg／L,respectively,which in the observation group were (0.14 ± 0.03)g／L,(0.06 ±0.03) mg／L, respectively, the indicators of proteinuria in both two groups were significantly improved (t＝3.97,4.38,all P＜0.05),and the indicators of proteinuria in the observation group were significantly improved compared with the control group (t＝3.84,3.99,all P＜0.05).Before treatment,the serum creatinine and urea nitrogen levels in the control group were (150.97 ±23.82)μmol／L,(13.57 ±2.24) mmol／L,respectively,which in the observation group were (162.73 ±21.75) g／L,(14.05 ±2.31) mmol／L,respectively,there were no statistically significant differences in renal function between the two groups (t＝1.02,0.93,all P＞0.05).After treatment,the levels of serum creatinine and urea nitrogen in the control group were ( 122.38 ±18.34 ) μmol／L, ( 8.72 ± 0.71)mmol／L,respectively,which in the observation group were (101.41 ±15.64) g／L,(5.11 ±0.68) mmol／L, respectively,and the indicators of renal function in both two groups were significantly improved (t＝5.31,6.47,4.92, 6.33,all P＜0.05).The indicators of renal function in the observation group were significantly improved compared with the control group ( t＝4.96,5.14,all P＜0.05).Before treatment,the levels of TNF －αand IL －6 in the control group were (28.28 ±4.75) ng／L,(17.13 ±4.46) ng／L,respectively,which in the observation group were (27.87 ±4.81)ng／L,(16.98 ±4.27) ng／L,respectively,there were no statistically significant differences in IL －6 and TNF－αlevels between the two groups (t＝0.86,0.97,all P＞0.05).After treatment,the levels of TNF－αand IL－6 in the control group were (19.72 ±4.21)ng／L,(14.35 ±3.25) ng／L,respectively,which in the observation group were (14.61 ±3.18)ng／L,IL－6 (11.28 ±3.09)ng／L,respectively,the levels of TNF－αand IL－6 in the two groups were significantly improved (t＝5.83,8.24,4.66,7.38,all P＜0.05).The levels of TNF－αand IL－6 in the observation group were significantly improved compared with the control group (t＝4.32,3.89,all P＜0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups ( P＞0.05).Conclusion Alprostadil combined with Tripterygium wilfordii polyglycosides can significantly improve the clinical efficacy of diabetic nephropathy ,with fewer adverse reactions and high safety ,which may be related to its ability to regulate the expression of serum TNF －αand IL－6.